Intervention proposal
“All the information contained in this section is for guidance only. Psious environments are therapy supporting tools that must be used by the healthcare professional within an evaluation and intervention process designed according to the characteristics and needs of the user.
Also remember that you have the General Clinical Guide in which you have more information on how to adapt psychological intervention techniques (exposure, systematic desensitization, cognitive restructuring, chip economy…) to Psious environments.”
As detailed below, a treatment protocol is offered as an example. It includes the Treatment protocol based on Psious Manual Acrophobia use of Psious combined with traditional techniques. Nevertheless we recommend the healthcare professional to adjust the VRʼs strategies to the techniques he already uses in his clinic practice. Moreover, the techniques will have to be adjusted to the needs and evolution of the patient, but especially to the exposure hierarchy, which healthcare professional and patient should elaborate in the first session
SESSION 1: PSYCHOEDUCATION
- Information about acrophobia is provided (origin, upkeep and appearance of the triple system cognitive, physiological and motor).
- Treatment techniques that will be used throughout the protocol are explained (emphasizing the exposure to the VirtualReality environments).
- An exposure hierarchy is elaborated.
SESSION 2 and 3 : RELAXATION
- The patient learns and practices two types of relaxation techniques: controlled breathing and Jacobson’s progressive muscular relaxation.
- Familiarization with the Psious platform. The patient learns to use the VR helmets and navigate inside the virtual scenes.
HOMEWORK
Daily practice of relaxation techniques. The self registers of relaxation and negative thoughts are completed (See appendix section)
SESSION 4: COGNITIVE RESTRUCTURING
- Revision and adjustment of the patient’s negative thoughts.
- Cognitive restructuring for each of the negative thoughts. Two kinds of cognitive therapy may be used: the one proposed by Beck or the one belonging to Ellis.
HOMEWORK
Daily practice of relaxation techniques. Self-registers of relaxation and negative thoughts are completed (See appendix section)
SESSION 5: VIRTUAL EXHIBITION + RELAXATION
- As of the fifth session of treatment the gradual and systematic exposure to the virtual environments begins. Throughout all exposure sessions, VR is combined with techniques of relaxation and cognitive restructuring.
- The patient is exposed to:
- Bridge and/or Cliff
- Getting to the second level of the crystal elevator
HOMEWORK
Daily practice of the relaxation techniques, selfregister of relaxation and negative thoughts and tasks of self exposure to stimulus related to heights..
SESSION 6: EXHIBITION RV + TRADITIONAL TECHNIQUES
- Homework review.
- The patient is exposed to:
- Getting to the terrace by the crystal elevator introducing interoceptive exposure and leaning to the rail.
- Getting to the terrace by the crystal elevator introducing a breakdown
HOMEWORK
Daily practice of relaxation techniques, self-registers and tasks of self-exposure to height related stimuli.
SESSION 7: EXHIBITION RV + TRADITIONAL TECHNIQUES
- Homework review.
- The patient is exposed to:
- Getting to the terrace by the metal elevator.
HOMEWORK
Daily practice of relaxation techniques, self-registers and self-exposure tasks to height related stimuli.
SESSION 8: EXHIBITION RV + TRADITIONAL TECHNIQUES
- Homework review
- The patient is exposed to:
- Getting to the terrace by the metal elevator introducing interoceptive exposure.
HOMEWORK
Daily practice of relaxation techniques, self-registers and self-exposure tasks to height related stimuli.
SESSION 9: EXHIBITION RV + TRADITIONAL TECHNIQUES
- As of the ninth session of treatment the exposure is re-started to the virtual environments but with a higher level of difficulty. With this scenario, we propose to examine the thoughts of the patient and the achieved results. Like in the rest of the exposure it is used in combination with relaxation and cognitive restructuring.
- The patient is exposed to:
- New York or Barcelona.
HOMEWORK
Daily practice of relaxation techniques, self-registers and self exposure tasks to height related stimuli.
SESSION 10: RELAPSE PREVENTION
- Homework review.
- The therapeutic process is evaluated and future self-exposure tasks are programmed, as well as booster sessions.
- Relapse management and prevention.